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NPI Code Detail

MEDICARE: PAUL GOLDBERG MD

MEDICARE:   PAUL  GOLDBERG  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianME53461FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649269903
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL GOLDBERG MD
Provider Business Mailing Address
First Line : 7800 SW 87TH AVE
Second Line : SUITE C-350
City : MIAMI
State : FL
Zip : 33173-2539
Country : US
Telephone Number : 954-731-9676
Fax Number : 954-731-9747
Provider Business Practice Location Address
First Line : 11011 SHERIDAN ST
Second Line : SUITE 311
City : HOLLYWOOD
State : FL
Zip : 33026-1532
Country : US
Telephone Number : 954-435-7400
Fax Number : 954-433-5402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 07/16/2015

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